摘要
目的 血液透析(HD)中低血压非常常见,有几种不同的处理方法。本研究主要探讨比较几种不同的处理方法哪个更优。方法 12例血液透析中常发生低血压的患者纳入观察对象。四种不同的透析方法①高钠透析:透析治疗前4小时用高钠透析液(透析液钠浓度:150mmol/L),结束前半小时钠浓度调至135mmol/L。②单纯超滤+HD:透析开始前30分钟单纯超滤,以后4小时透析。③低温透析:整个透析中透析液温度调至34.5℃-35.5℃。④低温透析+高钠透析。结果 四种透析方式的透析效能并无差异,高钠透析、低温透析、以及低温+高钠透析对于稳定血压均明显优于标准透析(透析液钠浓度140mmoL/L、温度37℃)组。单纯超滤+HD并不能减少低血压发生率。结论 本研究提示对于反复发生低血压的透析患者临床首选高钠透析、低温透析以及低温+高钠透析。透析间期增重大于2.8kg的透析患者,单纯超滤+HD并不能降低低血压的发生率。
Objective Intradialytic hypotension (IH) is a common complication during dialysis. There are several commonly utilized therapies of IH, however they have not been compared in the same group. The purpose of this study is to investigate the effects of different protective strategies on preventing dialysis hypotension. Methods A single - blind study was undertaken in 12 hemodialysis patients with a prior history of IH. First each patient took for standard dialysis (dialysate sodium 140mmol/L). Then each patient was subjected to take one week each of the four test protocols for. The specific protocols were as follows: high sodium dialysate in which the dialysate sodium was 150mmol/L during first four hours,and followed by a dialysate sodium of 135mmol/L during the last 30 minutes; simple isolated ultrafiltration + HD, in which 1/2 hour of isolated ultrafiltration followed by four hours of isovolemic dialysis; cool temperature dialysis, in which the dialysate was cooled to 34.5℃ - 35.5℃ ; and cool dialysate + high sodium dialysis. Results There were significantly fewer hypotensive episodes of follow treatments as the high sodium dialysis, cool dialysis and cool dialysis + high sodium dialysis compared with the standard protocol. Ultrafiltration followed by dialysis could not decrease the episodes of hypotension. Conclusion This study suggests that cool temperature dialysis and high sodium dialysis are of benefit to patients with IH, and for those whose weight loss are more than 2.8kg, ultrafiltration followed by dialysis could not diminish the episodes of hypotension.
出处
《中国血液净化》
2003年第4期189-191,共3页
Chinese Journal of Blood Purification
